Danger periods for suicide in patients under treatment

Copas, J. B.; Freeman-Browne, D L; Robin, A. A.

doi:10.1017/s0033291700044780

Cited by 25 publications

(6 citation statements)

References 3 publications

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“…Copas and his colleagues (6), seeking to identify the danger periods for suicide during treatment of depression, conducted a retrospective study of 29 patients who committed suicide while they were in treatment. The authors looked at suicide risk in relation to length of treatment.…”

Section: The Datamentioning

confidence: 99%

Are Patients With Depression at Heightened Risk of Suicide as They Begin to Recover?

Mittal¹,

Brown²,

Shorter³

2009

Psychiatric Services

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It has long been taught and believed that patients with depression and suicidal tendencies are at heightened risk of suicide as they begin to recover and their energy and motivation return. What are the data behind this enduring belief? More than a century ago, eminent clinicians noted that some patients with depression committed suicide just as their depression seemed to be improving. The clinicians went on to warn that early recovery carries a high risk of suicide. Although no studies have tracked suicide along with symptomatic change in depression, recent large-scale studies of suicide and phase of treatment do not indicate that suicide is more likely to occur early in recovery than at other times. Our forebears helpfully pointed out that patients with depression may commit suicide as they are beginning to recover. But the idea that these patients are at particular risk of suicide at this time, intuitively plausible as it is, remains to be substantiated.

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Section: The Datamentioning

confidence: 99%

Are Patients With Depression at Heightened Risk of Suicide as They Begin to Recover?

Mittal¹,

Brown²,

Shorter³

2009

Psychiatric Services

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“…The beginning of an acute relapse and the recovery period represent the times of maximum risk during an episode of illness (Copas et al 1971;Gale et al 1980 (Coser 1976;Crammer 1984; Kahne 1968), and inadequate ward design or location (Crammer 1984;Sims & O'Brien 1979) have been linked to hospital suicides. (Piatt et al 1988).…”

Section: Episodementioning

confidence: 99%

Suicidal behaviour in childbearing women

Appleby

1996

International Review of Psychiatry

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The first postnatal year is a period when the rate of psychiatric disorder is high, and a correspondingly high rate of suicide might be expected. Age-adjusted mortality ratios for suicide by women in the first postnatal year were therefore calculated from population data for England and Wales for a twelve-year period. The overall mortality ratio was found to be 17-that is, the actual total was one sixth of that expected. The low rate was not found after stillbirth which was associated with a rate of suicide six times that in all women after childbirth. Women who committed suicide after childbirth most often did so in the first postnatal month and there was a tendency to use violent methods. One explanation of the low rate of suicide is that motherhood exerts a protective effect, and further studies were carried out to explore this possibility. In study two, the age-standardised mortality ratio for suicide during pregnancy was calculated by the same method to be 5-that is, the actual rate was one twentieth of that expected. In study three, the rate of parasuicide by women in the first postnatal year was calculated from catchment area data to be less than half that of age-matched women (odds ratio 0.43). In study four, a cognitive explanation for these results was studied. Women with postnatal depression were found to score less on a questionnaire measuring cognitions related 1 to worthlesness, hopelessness and self-harm than women with depression arising at other times. This result suggests that childbearing women, despite their risk of psychiatric disorder, are protected against suicide and self-harm by their relative absence of suicide-related cognitions, and that such cognitions should be a focus for the treatment of other groups at risk of suicide.

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“…High suicide rates are particularly associated with acute episodes of illness,2 recent hospital discharge, 34 social factors such as living alone,5 and features of clinical history such as substance misuse6 and non-fatal self harm 7. However, comparatively little is known about the clinical care being provided to psychiatric patients before suicide.…”

Section: Introductionmentioning

confidence: 99%

Suicide within 12 months of contact with mental health services: national clinical survey

Appleby

Shaw

Amos

et al. 1999

BMJ

430

284

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Several suicide prevention measures in mental health services are implied by these findings, including measures to improve compliance and prevent loss of contact with services. Inpatient facilities should remove structural difficulties in observing patients and fixtures that can be used in hanging. Prevention of suicide after discharge may require earlier follow up in the community. Better suicide prevention in psychiatric patients is likely to need measures to improve the safety of mental health services as a whole, rather than specific measures for people known to be at high risk.

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Danger periods for suicide in patients under treatment

Abstract: SYNOPSISUsing statistical methods, the hypothesis that suicide occurs either at the beginning or at the end of a spell of treatment is shown to fit the available data.

Cited by 25 publications

References 3 publications

Are Patients With Depression at Heightened Risk of Suicide as They Begin to Recover?

Are Patients With Depression at Heightened Risk of Suicide as They Begin to Recover?

Suicidal behaviour in childbearing women

Suicide within 12 months of contact with mental health services: national clinical survey

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